Okla. Stat. tit. 56, § 56-1012.4
This is the official text of Okla. Stat. tit. 56, § 56-1012.4, part of Oklahoma’s Stat. tit. 56, — part of the compiled statutory law of Oklahoma, published by the state as "Stat. tit. 56,." Browse the sections below, each linked to its official government source.
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Regulations and policies for CRT products and services
Official statutory text
The Oklahoma Health Care Authority shall establish focused
regulations and policies for CRT products and services. These
focused regulations and policies shall take into consideration the
customized nature of CRT and the broad range of services necessary
to meet the unique medical and functional needs of people with
complex physical disabilities by:
1. Designating specific HCPCS billing codes as CRT and, as
needed, creating new billing codes or modifiers for services and
products covered for people with complex physical disabilities;
2. Establishing specific supplier standards for companies or
entities that provide CRT and restricting the provision of CRT to
only qualified CRT suppliers that meet such standards as defined in
Section 3 of this act;
3. Requiring complex-needs patients receiving a complex
rehabilitation manual wheelchair, power wheelchair, or seating
component to be evaluated by:
a. a qualified health care professional as defined in
Section 3 of this act, and
b. a qualified complex rehabilitation technology
professional as defined in Section 3 of this act;
4. Maintaining payment policies and rates for complex
rehabilitation technology to ensure payment amounts are adequate to
provide people with complex physical disabilities with access to
such items. Such policies and rates shall take into account the
significant resources, infrastructure, and staff needed to
appropriately provide CRT to meet the unique needs of complex-needs
patients;
5. Exempting the HCPCS billing codes defined in Section 3 of
this act from inclusion in any bidding, selective contracting, or
similar such initiative, if the specialty provider service,
specialized equipment or supply can only be obtained from a sole
source;
6. Requiring that Managed Care Medicaid plans adopt the
regulations and policies outlined in this act and contract with any
willing, qualified CRT supplier; and
7. Making other changes as needed to protect access to CRT for
complex-needs patients.
regulations and policies for CRT products and services. These
focused regulations and policies shall take into consideration the
customized nature of CRT and the broad range of services necessary
to meet the unique medical and functional needs of people with
complex physical disabilities by:
1. Designating specific HCPCS billing codes as CRT and, as
needed, creating new billing codes or modifiers for services and
products covered for people with complex physical disabilities;
2. Establishing specific supplier standards for companies or
entities that provide CRT and restricting the provision of CRT to
only qualified CRT suppliers that meet such standards as defined in
Section 3 of this act;
3. Requiring complex-needs patients receiving a complex
rehabilitation manual wheelchair, power wheelchair, or seating
component to be evaluated by:
a. a qualified health care professional as defined in
Section 3 of this act, and
b. a qualified complex rehabilitation technology
professional as defined in Section 3 of this act;
4. Maintaining payment policies and rates for complex
rehabilitation technology to ensure payment amounts are adequate to
provide people with complex physical disabilities with access to
such items. Such policies and rates shall take into account the
significant resources, infrastructure, and staff needed to
appropriately provide CRT to meet the unique needs of complex-needs
patients;
5. Exempting the HCPCS billing codes defined in Section 3 of
this act from inclusion in any bidding, selective contracting, or
similar such initiative, if the specialty provider service,
specialized equipment or supply can only be obtained from a sole
source;
6. Requiring that Managed Care Medicaid plans adopt the
regulations and policies outlined in this act and contract with any
willing, qualified CRT supplier; and
7. Making other changes as needed to protect access to CRT for
complex-needs patients.
Status: in_force · Read it on the official government site
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